Drug detoxification (informally, drug detox) is variously the intervention in a case of physical dependence to a drug; the process and experience of a withdrawal syndrome; and any of various treatments for acute drug overdose.

Medical detoxification safely manages the acute physical symptoms of withdrawal associated with stopping drug use. However, medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Although detoxification alone is rarely sufficient to help addicts achieve long-term abstinence, for some individuals it is a strongly indicated precursor to effective drug addiction treatment.

A detoxification program for physical dependence does not necessarily address the precedents of addiction, social factors, psychological addiction, or the often-complex behavioral issues that intermingle with addiction.

The United States Department of Health and Human Services acknowledges three steps in a drug detoxification process:

  1. Evaluation: Upon beginning drug detoxification, a patient is first tested to see which specific substances are presently circulating in their bloodstream and the amount. Clinicians also evaluate the patient for potential co-occurring disorders, dual diagnosis, and mental/behavioral issues.
  2. Stabilization: In this stage, the patient is guided through the process of detoxification. This may be done with or without the use of medications but for the most part the former is more common. Also part of stabilization is explaining to the patient what to expect during treatment and the recovery process. Where appropriate, people close to the addict are brought in at this time to become involved and show support.
  3. Guiding Patient into Treatment: The last step of the detoxification process is to ready the patient for the actual recovery process. As drug detoxification only deals with the physical dependency and addiction to drugs, it does not address the psychological aspects of drug addiction. This stage entails obtaining agreement from the patient to complete the process by enrolling in a drug rehabilitation program.

Alcohol detoxification, or detox, for individuals with alcohol dependence, is the abrupt cessation of alcohol intake, a process often coupled with substitution of cross-tolerant drugs that have effects similar to the effects of alcohol in order to prevent alcohol withdrawal.

As such, the term “detoxification” may be somewhat of a misnomer since the process need not refer exclusively to the removal of toxic substances from the body. Detoxification may or may not be indicated depending upon an individual’s age, medical status, and history of alcohol intake. For example, a young man who binge drinks and seeks treatment one week after his last use of alcohol may not require detoxification before beginning treatment for alcoholism.

Benzodiazepines such as chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan) or oxazepam (Serax) are the most commonly used drugs used to reduce alcohol withdrawal symptoms. There are several treatment patterns in which it is used.

The first option takes into consideration the varying degrees of tolerance. In it, a standard dose of the benzodiazepine is given every half-hour until light sedation is reached. Once a baseline dose is determined, the medication is tapered over the ensuing 3–10 days.

Another option is to give a standard dose of benzodiazepine based on history and adjust based on withdrawal phenomenon.

A third option is to defer treatment until symptoms occur. This method should not be used in patients with prior, alcohol-related seizures. This has been effective in randomized controlled trials. A non-randomized, before and after, observational study found that symptom triggered therapy was advantageous.

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Source: drugabuse.gov, wikipedia.org

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